DEXA scan explained: who needs a bone density test
What a DEXA bone density scan measures, who needs one, and what T-score and FRAX results mean, in plain words. From Aggarwal Clinic, The Mall, Patiala.
A DEXA scan, also written DXA, is a bone density test. This page explains what it measures, who usually needs one and what the numbers on the report mean. Your doctor reads your own report with you, along with your other risk factors.
The page is for men and women. The guidance below on who needs a scan comes from guidelines written for women. Men can have weak bones too. In 2022, the US Bone Health and Osteoporosis Foundation suggested a scan for men 70 and over, and for men 50 to 69 with risk factors. The International Society for Clinical Densitometry, ISCD, says much the same: men 70 and over, and younger men with risk factors. Experts differ here: the US Preventive Services Task Force, USPSTF, found in 2025 that there is not yet enough evidence to say whether men should be screened. Ask your doctor whether you need one.
What is a DEXA scan?
A DEXA scan measures bone density, which means how much mineral is in your bone. It usually looks at the hip and the spine. Your doctor uses the result together with your other risk factors to judge your chance of a fracture, which means a broken bone.
Who needs one?
For women around menopause, the Indian Menopause Society lists these groups:
- women who have broken a bone after a small fall
- women with an illness or a medicine that weakens bone
- women whose X-ray shows thin bone or a spine fracture
- women about to start a bone medicine
After menopause, it adds every woman more than 5 years past her last period. It also adds younger women who have risk factors. In the US, guidance advises screening women at 65, or earlier after menopause if the risk is higher.
What about men?
Most of the guidance above was written for women, and women’s research should not be applied to men. The evidence on scanning men is weaker.
The International Society for Clinical Densitometry, ISCD, suggests a DEXA scan for:
- men aged 70 or over
- men under 70 with a risk factor, such as low body weight, a previous broken bone, a medicine or an illness that causes bone loss
- anyone who breaks a bone in a small fall
- anyone about to start, or already taking, a bone medicine
As noted above, the USPSTF found in 2025 that there is not enough evidence to recommend for or against screening men.
For men under 50, the report uses a Z-score, which compares you with men of your own age, instead of a T-score. In men under 50, osteoporosis cannot be diagnosed from the scan result alone.
A normal scan lowers the worry but does not mean a bone can never break. Ask your doctor whether you need a scan.
What does the T-score mean?
The T-score compares your bone density with that of a healthy young adult.
- A score of -2.5 or lower means osteoporosis, which means weak, thin bones.
- A score that is low but above -2.5 is called osteopenia, which means low bone mass.
What is FRAX?
FRAX is a risk tool. It uses your age and risk factors, with or without the scan result. It estimates your chance of a fracture in the next 10 years.
The Indian version of FRAX is based on a small study. It may show a lower risk than the true one, so your doctor looks at it alongside your other risk factors. Where no scan is available, doctors may start with a simple check based on age and weight, called OSTA.
If my score is low, do I need medicine?
Not always. Doctors usually advise medicine in these cases:
- a broken bone after a small fall
- a T-score of -2.5 or lower
- a high FRAX score
With osteopenia alone, the decision usually depends on FRAX, not on the T-score alone.
How often should the scan be repeated?
For women around menopause, the Indian Menopause Society suggests every 1 to 5 years, depending on your risk. For men on a bone medicine, the US Bone Health and Osteoporosis Foundation advises a repeat scan 1 to 2 years after starting or changing it, then as the doctor decides. Men not on treatment should ask their doctor how often they need one. Have it on the same machine and at the same body site each time, so the results can be compared.
Related guides
For doctors
The evidence behind this page is in Osteoporosis questions and evidence answers, Bone health in perimenopause and Fracture risk in perimenopause.
Sources for men
- ISCD official positions: PMID 31400968
- US Bone Health and Osteoporosis Foundation, Clinician’s Guide 2022: PMID 35478046
- USPSTF 2025: PMID 39808425
Talking to a doctor in Patiala
To talk about your bone health or your DEXA report with Dr Aditya Aggarwal, orthopaedic surgeon, call Aggarwal Clinic on +91 98768 24676.
Aggarwal Clinic, 1-E, The Mall, Patiala.
This page is general information, not medical advice. Please talk to your doctor about what is right for you.
Questions
Common questions
- What is a DEXA scan?
- A DEXA scan, also written DXA, measures bone density, which means how much mineral is in your bone. It usually looks at the hip and spine. Doctors use the result with your other risk factors to judge your chance of a broken bone.
- What does a T-score of -2.5 mean?
- The T-score compares your bone density with that of a healthy young adult. A score of -2.5 or lower means osteoporosis, which means weak, thin bones. A score that is low but above -2.5 is called osteopenia, which means low bone mass.
- If my bone density is low, do I need medicine?
- Not always. Doctors usually advise medicine after a broken bone from a small fall, a T-score of -2.5 or lower, or a high FRAX score. With osteopenia alone, the decision usually depends on FRAX, not on the T-score alone.
- How often should a DEXA scan be repeated?
- For women around menopause, the Indian Menopause Society suggests every 1 to 5 years, depending on your risk. Use the same machine and the same body site each time so the results can be compared.
Last reviewed
General information only; it doesn’t replace a consultation. In an emergency, call 112.